Bladder training

Bladder training (also called bladder retraining) is used to
treat urge incontinence. Bladder training attempts to increase how long you can
wait before having to urinate. You are taught about the structure of the lower
urinary tract and the causes of incontinence.

A schedule for urinating is established, and you are trained to
resist the first urge to urinate and to refrain from urinating until the
scheduled time. The interval between scheduled bathroom visits is increased
until you can refrain from urinating for several hours.

Biofeedback

Biofeedback is
a technique for learning to control a body function that is not normally under
conscious control, such as skin temperature, muscle tension, heart rate, or
blood pressure.

People with incontinence are taught bladder-sphincter
biofeedback methods along with pelvic floor exercises. During biofeedback, bladder, rectal sphincter, and abdominal pressures as well as electrical
activity are recorded and displayed for you. By watching
the information, you learn to relax your bladder and abdominal (belly) muscles and
contract your pelvic floor muscles based on the information displayed.

Women may also use a weighted cone inserted in the vagina as a biofeedback technique during pelvic floor muscle training.

Learning biofeedback requires practice in a lab or other setting with
the guidance of a trained therapist. Home biofeedback units also are
available.

Pelvic floor muscle training

Pelvic floor (Kegel) exercises can help strengthen
some of the muscles that control the flow of urine. These exercises are used to treat urge
or stress incontinence. To do Kegel exercises:

Squeeze the same muscles you would use to stop your urine. Your belly and thighs should not move.

Hold the squeeze for 3 seconds, then relax for 3 seconds.

Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.

Repeat the exercise 10 to 15 times a session. Do three or more sessions a day.

Kegel exercises can be done when you are at home or away
from home. They can be done at any time of day. No one will be aware that you are
doing the exercises. So you can do them often, no matter where you are.

Kegel exercises are often combined with biofeedback techniques to teach
the proper exercise methods and to make sure the exercise is working. To be
effective, pelvic floor (Kegel) exercises with or without biofeedback
techniques require a high level of motivation and frequent repetition.

What To Expect After Treatment

These methods are often successful in reducing
or stopping urinary incontinence.

Why It Is Done

Behavioral methods may be used to treat:

Urge incontinence (using bladder
training).

Stress and urge incontinence (using pelvic muscle exercises).

How Well It Works

Bladder training

Bladder training does not work well for
everyone. But some people benefit significantly.

Many people who
use bladder training have fewer symptoms of incontinence. For some people, the
incontinence completely stops.

Biofeedback

There is not a lot of evidence
for biofeedback combined with other behavioral therapies for urinary incontinence. More research
is needed.

Pelvic floor muscle training in men

Two reviews were done of men using pelvic floor muscle
training to improve continence after prostate surgery. Results were not the same, but there does seem to be a benefit in men who do pelvic floor muscle exercises. One review showed that pelvic floor muscle training did help men
control leakage of urine after a radical prostatectomy for prostate
cancer.1 But the other review showed no benefit overall
in men trying pelvic floor muscle training after any prostate surgery.2

Another study showed that men who did pelvic floor muscle exercises after prostate surgery had much improved urine leakage compared to men who did not do the exercises.3

Pelvic floor muscle training in women

Women who do Kegel exercises are more likely to improve, and even cure, their incontinence. These women had
fewer leakage problems a day and said their quality of life was better.4 Women who do these exercises during and after pregnancy can reduce their chance of urine leakage after delivery.4

Women who did these exercises for urinary incontinence (urge, stress, or mixed incontinence) got better. The exercises seem to work better in women who have stress urinary incontinence and who keep doing the exercises.5

Risks

No risks are associated with these treatments.

What To Think About

Behavioral methods such as bladder training require a high level of
motivation.

To be effective, pelvic floor (Kegel)
exercises with or without biofeedback techniques require a high level of
motivation and frequent repetition.

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